[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-373767-105":59,"doc-detail-373767-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","from-diagnosis-to-treatment-navigating-the-course-for-pancreatic-neuroendocrine-neoplasms","From diagnosis to treatment - navigating the course for pancreatic neuroendocrine neoplasms","","Pancreatic neuroendocrine neoplasms (pNENs) are an increasingly significant and complex subgroup of neuroendocrine diseases, marked by heterogeneity in biology, metastatic risk, functionality, and aetiology. This review synthesizes current knowledge from diagnosis through treatment, describing recent classification changes that separate three grades of well-differentiated tumours from poorly differentiated neuroendocrine carcinomas. It highlights the rising incidence, varied clinical presentations, and the need for adaptable, multidisciplinary personalized management.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/from-diagnosis-to-treatment-navigating-the-course-for-pancreatic-neuroendocrine-neoplasms/373767/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/from-diagnosis-to-treatment-navigating-the-course-for-pancreatic-neuroendocrine-neoplasms/373767.png","ImageObject",300,407,{"name":92,"@type":93},"Bulrr","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",18,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What makes pancreatic neuroendocrine neoplasms (pNENs) clinically challenging to manage?","Question",{"text":113,"@type":114},"pNENs are highly heterogeneous, with wide variations in biological behaviour, metastatic potential, functionality, and aetiology, which complicates both diagnosis and treatment planning.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How has the classification of pNENs changed in recent advances?",{"text":118,"@type":114},"Recent advances have led to a classification that distinguishes three grades of well-differentiated tumours from poorly differentiated neuroendocrine carcinomas.",{"name":120,"@type":111,"acceptedAnswer":121},"What treatment approach is recommended for localized versus advanced pNENs?",{"text":122,"@type":114},"For localized and locally advanced tumours, surgery remains the primary curative-intent approach. For advanced disease, systemic therapy is often the only option and the cornerstone of care.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},373767,1790259013,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},5909892115043,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","AnnAls of Medicine  \n2025, Vol. 57, no. 1, 2569992  \n[https://doi.org/10.1080/07853890.2025.2569992](https://doi.org/10.1080/07853890.2025.2569992)  \nREVIEW ARTICLE     \nFrom diagnosis to treatment: navigating the course for pancreatic neuroendocrine neoplasms  \nLara Mastnaka and David Badovinacb,c   \nadivision of internal Medicine, University Medical centre ljubljana, ljubljana, slovenia; bdepartment of surgery, faculty of Medicine, University of ljubljana, ljubljana, slovenia; cdepartment of Abdominal surgery, University Medical centre ljubljana, ljubljana, slovenia  \nABSTRACT  \nIntroduction: Pancreatic neuroendocrine neoplasms (pNENs) represent an increasingly significant, unique and complex subgroup of neuroendocrine diseases. Their heterogeneity is reflected in wide variations in biological behaviour, metastatic potential, functionality and aetiology. This review synthesizes the current understanding of pNENs, from diagnosis to treatment.  \nDiscussion: Recent advances in understanding of these neoplasms have led to significant changes in their classification, now distinguishing three grades of well-differentiated tumours from poorly differentiated neuroendocrine carcinomas. These neoplasms are rare and can occur sporadically or within the context of hereditary syndromes, however, due to advances in diagnostic modalities and ageing population their incidence worldwide is on the rise. They can present as functional neoplasms, secreting biologically active hormones and inducing hormonal syndromes, or as non-functional neoplasms. Surgery remains the primary curative-intent approach for localized and locally advanced tumours, while systemic treatment is often the only option for patients with advanced disease. Multifaceted nature of pNENs demands a multidisciplinary approach that incorporates personalized diagnostic and therapeutic strategies. While clinical guidelines provide an essential framework, they must remain adaptable to accommodate individual patient circumstances and evolving evidence. Conclusions: This review addresses existing gaps, unresolved controversies and areas of inconsistency in diagnostic workup and management of pNENs. It underscores the need for continued investigation to refine our understanding and improve patient outcomes.  \nKEY MESSAGES  \nThe growing worldwide incidence of pancreatic neuroendocrine neoplasms demands profound and up-to-date knowledge on diagnostic and therapeutic modalities. Their complex and versatile pathology necessitates a multidisciplinary approach to ensure optimal management for each individual patient. In localized disease, treatment is guided by tumour size and functionality, with active surveillance or surgery as mainstays. In advanced disease, systemic therapy remains the cornerstone of care.  \n1. Introduction 1.1. Background  \nARTICLE HISTORY  \nReceived 12 February 2025  \nAccepted 23 September 2025  \nKEYWORDS  \nPancreatic neuroendocrine  \nneoplasms; multidisciplinary management; diagnosis; treatment strategies; clinical guidelines  \nNeuroendocrine neoplasms (NENs) are a unique and diverse group of diseases that span a spectrum from indolent to highly aggressive malignancies [1] . Although all NENs possess the potential for malignancy, their biological behaviour and metastatic risk can vary dramatically, posing significant challenges in diagnosis and management [2] . Histologically, these neoplasms are distinguished by their affinity for silver staining and the expression of hallmark neuroendocrine markers such as synaptophysin (SYP) and chromogranin A (CgA) [1] .  \nCONTACT david Badovinac  [david.badovinac@kclj.si](david.badovinac@kclj.si)  department of Abdominal surgery, University Medical centre ljubljana, Zaloska 7, 1000 ljubljana, slovenia.  \n© 2025 The Author(s) . Published by informa UK limited, trading as Taylor & francis Group  \nThis is an open Access article distributed under the terms of the creative commons Attribution-noncommercial license ([http://creativeco","cbCaitdS1Dn7X4gt","https://ap.wps.com/l/cbCaitdS1Dn7X4gt","pdf",1082366,26,"English","# Key messages\n# 1. Introduction\n## 1.1. Background","[{\"question\":\"What makes pancreatic neuroendocrine neoplasms (pNENs) clinically challenging to manage?\",\"answer\":\"pNENs are highly heterogeneous, with wide variations in biological behaviour, metastatic potential, functionality, and aetiology, which complicates both diagnosis and treatment planning.\"},{\"question\":\"How has the classification of pNENs changed in recent advances?\",\"answer\":\"Recent advances have led to a classification that distinguishes three grades of well-differentiated tumours from poorly differentiated neuroendocrine carcinomas.\"},{\"question\":\"What treatment approach is recommended for localized versus advanced pNENs?\",\"answer\":\"For localized and locally advanced tumours, surgery remains the primary curative-intent approach. For advanced disease, systemic therapy is often the only option and the cornerstone of care.\"}]","From diagnosis to treatment - navigating the course for pancreatic neuroendocrine neoplasms | PDF",1790200398,66]